Zika virus and its clinical implications: a comprehensive review

Recent Zika virus outbreak in Latin America and the Caribbean has drawn the world’s attention toward this relatively unknown virus, with WHO declaring it a public health emergency of international concern (PHEIC). India has had its own tryst with Zika virus with that “significant numbers” of Indians had already been exposed to Zika as early as 1950s. An exponential spread of Zika virus is a potential public health concern, with implications requiring immediate action. The devastating complications of Zika virus infection, particularly congenital and neurological, makes imperative a thorough, thoughtful, and level-headed public health approach in dealing with this infection especially during pregnancy. We review the data on this deadly infection in this brief review including its history, epidemiology, clinical features and management aspects particularly in pregnant women

A rare cause of bleeding gastric ulcer: multiple myeloma

The causes of GI bleed are many and varied with peptic ulcers accounting for about 50% cases. Multiple myeloma is the most common lymphoid neoplasm in older adults and accounts for approximately 10% of all hematologic malignancies. Extraosseous manifestations are said to be present in less than 5% of patients with Multiple Myeloma with GI ulcers only being described rarely. In this report we describe a case of a 58 year old lady presenting with weakness, palpitations, gum bleeding with recent onset melena. She had severe anaemia with thrombocytopenia and markedly elevated ESR. An UGI endoscopy revealed a 1x0.5 cm ulcer infiltrated by lymphoplasmacytic cells and histiocytes with a few neutrophils. Serum globulin fraction was markedly high and Serum protein electrophoresis revealed it to be a case of multiple myeloma with Igʎ secreting monoclonal cells. Bone marrow aspirate revealed 40 % plasma cells with some binucleate and trinucleate forms. The patient was diagnosed as stage III multiple myeloma (International staging system) and treated with dexamethasone, zoledronic acid and thalidomide. Our case highlights a very atypical presentation of multiple myeloma and alerts the clinician to keep an eye of suspicion in dealing with peptic ulcer cases especially in the elderly

Periodontitis and diabetes: A bidirectional, cyclical relationship - A brief review

Diabetes mellitus and periodontitis have been said to have a bidirectional cyclical relationship, with diabetes leading to oral disease, and periodontitis, in turn, exacerbating hyperglycemia. Periodontitis is recognized as the sixth major complication of diabetes, having increased prevalence and severity in patients with diabetes. Early diagnosis of diabetes in patients with periodontitis can lead to the prevention of major morbidity and mortality associated with the disease. Therapy for diabetes may also lead to the improvement of periodontitis. In this review, we are presenting the current knowledge of the interplay and interaction between these two entities and the available data regarding treatment of the two entities together

Gestational diabetes mellitus: A diagnostic dilemma

Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. Despite decades of research and debate, confusion regarding screening and diagnostic criteria for GDM has been persistent. Despite initially been touted as the diagnostic criteria of choice, the Diabetes in Pregnancy Study Group India criteria themselves have been fraught with controversy. We review the disease and its history in brief with a timeline of different criteria proposed for its diagnosis which have only but added to dilemma in its diagnosis